Reforming pathology around the patient, UK Gov Health News

Health Minister Lord Warner today set out plans to reform pathology
services and bring about higher quality, more efficient, effective
and responsive services for patients.

The plans are a response to recommendations set out in the Report
of the Review of NHS Pathology Services in England, undertaken by Lord
Carter of Coles, which is published today.

Pathology services mainly cover blood tests, but also include taking
other specimens from patients - such as tissue samples - and post mortem
examinations. Pathology is at the heart of patient care - it is estimated
that 70% of all diagnoses involve a pathology investigation
and demand has been rising by 10% a year. Overall, pathology
services cost the NHS around £2.5bn a year.

Lord Carter's review found that, over time, several different models
of service delivery have evolved within pathology, from small in-house
laboratories to larger networks which has resulted in fragmentation
of services.

The plans to reform pathology services include:

£1 million funding to support 12 pilot projects to road-test
the recommendations of the review and to gather improved data on
activity, cost and performance of pathology services; and

in future,
bringing in new providers of pathology services, especially in
regard to routine tests.

Lord Warner said:

" I am very grateful to Lord Carter and his panel for this thorough
and comprehensive report whose direction of travel I support.

_ Pathology is a vital service for
patients. The review has found much good work already underway. But
pathology is a key part of diagnosing
seven in ten patients' conditions and the number and range of tests
continue to increase.

_ The review has confirmed we need
to improve efficiency and provide better, more convenient and speedier
services for patients. I believe
that patients can benefit from greater networking of services to help
us use capacity better.

_ There are clearly issues to be
tackled in terms of improving transportation of samples and notifying
patients of results. We need
to explore, as other countries have done, what lessons there are to
be learned from the independent sector, particularly in providing routine
tests. We need to look for substantial efficiency gains through new
ways of working that can be fully implemented in 2008/09. I am looking
for at least a 10% gain.

_ I have therefore asked Lord Carter
to oversee a programme of pilot projects which will trial the way
forward in partnership with
the NHS, and provide robust evidence to guide future reforms. I want
to move forward with a change programme for pathology services that
benefits patients, taxpayers and staff, and do so on a fully consultative
basis involving all interests."

Lord Carter of Coles said:

" Pathology is a vital aspect of the NHS and we have been consistently
impressed by the quality and commitment of the people who work within
it, especially given the steady rise in demand for pathology over recent
years. Yet we believe that staff, NHS commissioners and patients are
often poorly supported by a system that is both fragmented and inefficient.

_ We believe therefore that there
is a need for a much more integrated pathology service to improve
both its quality and status within the
NHS, and its responsiveness to patients. Our recommendations reflect
this goal.

_ There is however a need to ensure
that change of this sort is supported by key stakeholders, as well
as by good information and evidence,
and we consider it very important that our approach is piloted before
being introduced across the NHS."

The objective of the pilots would be to identify a new model for commissioning
and organising NHS pathology services that offers increased quality
and responsiveness to patients and reduces NHS costs.

Other recommendations of the Review include:

drawing up a clear commissioning specification or plan of regional
pathology requirements;

further work be undertaken to ensure end-to-end
IT connectivity and national availability of order communications
and decision support
within pathology; and

reform of the pathology workforce and greater
clarity with respect to roles, functions and equivalence in terms
of education and training
requirements.

Lord Carter will chair a project board that will oversee the pilot
projects. The projects' operational phase will begin in January 2007,
with roll-out across Strategic Health Authorities from autumn 2007
once the pilots have been evaluated, in line with commissioning plans,
and following full consultation with staff, professional and other
interests.

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